Docstoc

Causes of

Document Sample
Causes of Powered By Docstoc
					                                                                                                                                                                                                                                                                                         Medical


   Causes of
                                                                                                                                                                                                                                                                       problems conceiving

                                                                                                                                 Causes of infertility in men
                                                                                                                                                                                                                                             SO WHAT HAPPENS IF YOU DECIDE




   INFERTILITY
                                                                                                                                                                                                                                             TO GO FOR TREATMENT?
                                                                                                                                                                                                                                             First of all your GP or family planning nurse will
                                                                                                                      Penis                                                                                                                  want to find out if there is any reason why you
                                                                                                                      • Problems with ejaculation, or                                                                                        aren’t getting pregnant. They will check whether
                                                                                                                        impotence.
                                                                                                                                                                                                                                             you have had any previous illnesses or operations,
                                                                                                                                                                                                                                             whether either of you have any problems, such as
                                                                                                                                                                                                                                             irregular periods for the woman, and how often
                                                                                                                                                                                                                                             and at what time of the month you have sex. The
                                                                                                                                                                                                                                             questions can be embarrassing, but it is essential
     WHEN YOU DON’T GET PREGNANT                                                                                      Testes                                                                                                                 to check that there isn’t a simple explanation for
     If you have decided you want a baby then not                                                                     • Low sperm count, which may be                                                                                        the problem. Some people may just not be having
     getting pregnant can be devastating. But it is                                                                     the result of hormonal problems of                                                                                   sex at the most fertile time of the woman’s cycle.
     surprisingly common. One in seven couples are                                                                      previous illnesses such as mumps,
                                                                                                                        or a number of other reasons like                                                                                    The next step is some simple tests. For the woman
     affected by infertility at some point in their lives,                                                                                                                                                                                   there are blood and urine tests to check that
                                                                                                                        smoking and too much heat.
     but the good news is that even those who have                                                                    • Poor quality sperm, which are not                                                                                    ovulation has taken place. For men there is a
     not conceived for three years, the likelihood of                                                                   strong enough to swim up into the                                                                                    semen analysis to check the quality, quantity and
                                                                                                                                                                                                       Vas deferens
     getting pregnant in the end is 25%.                                                                                woman’s fallopian tubes.                                                       • Previous vasectomy.                 mobility of sperm. The family planning clinic can
                                                                                                                      • Enlarged veins within the testes,                                              • Blocked tubes from an infection.    also do a postcoital check, where 12 hours after
     Fertility treatment has made great progress and                                                                    called ‘varicocoele’, which prevent
     there are now many options available. We answer                                                                                                                                                                                         making love the mucus in the woman’s vagina is
                                                                                                                        the sperm from passing through.                                                                                      checked for live healthy sperm.
     some common questions.
                                                                                                                                                                                                                                             Other investigations are ultrasound and
     WHY CAN’T I GET PREGNANT?                                                                                          But very often there is no particular reason why a        WHEN SHOULD WE GO FOR HELP?                                laparoscopy – a procedure where a small camera
     It is an emotional thing when you don’t get                                                                        couple may be having difficulty in conceiving. It         This depends on how you feel, but 85% of couples           is used to see what is going on inside your body.
     pregnant. Very often people blame themselves and                                                                   could be due to stress or just a question of time.        will normally conceive after one year, it is a good        Finally, if there is still no sign of a pregnancy, the
     think it is their fault. Women can feel guilty and                                                                 When all the investigations have been done and            idea to seek help after twelve months. There may           couple may then want to consider fertility
     think, ‘I’m not a proper woman if I can’t have a                                                                   there is nothing obviously wrong physically with          be a reason why you are not conceiving which can           treatment, or ‘assisted conception’.
     baby’. For men it can be particularly hard,                                                                        either the man or the woman, it is called                 be treated. Visit your GP or your local family
     especially if the reason for the infertility is because                                                            ‘unexplained infertility’.                                planning clinic.
     of them – a low sperm count for example. Often
     couples find it difficult to admit that there is a




                                                                                                                       Q&A
     problem and don’t go for treatment. But there can
     be lots of reasons for infertility, many of which can
     be treated with great success.
                                                                                                                                                              Q We have found out that the reasonsperm count is low.
                                                                                                                                                                pregnant is because my partner’s
                                                                                                                                                                                                  I’m not getting                   feel he is a failure because he can’t get you pregnant. It
                                                                                                                                                                                                                                    might be a good idea to take a break from baby making
                                                                                                                                                                  Now he has completely gone off sex. Is this normal?               and to spend time doing things together that you both

                                                                                                                                                              A   It is not unusual for couples to find baby making stressful.
                                                                                                                                                                  Making love can become clinical and your partner may
                                                                                                                                                                                                                                    enjoy, to remind you why you wanted to be together in
                                                                                                                                                                                                                                    the first place.

        Causes of infertility in women                                                                                  Fertility treatment

                                                                                                                      Q I’ve readhave iftwins or triplets.you this more Q My partner was married before and had 3are Q After we’d been trying for a baby for
                                                                                                                        likely to
                                                                                                                                   that you have IVF
                                                                                                                                                           Is
                                                                                                                                                               are
                                                                                                                                                                   true?   children and then a vasectomy. Now we             eighteen months I went to the doctor. He
Ovaries
• May not be producing eggs. This could be for a number of
                                                               Fallopian tubes
                                                               • May be blocked because of a previous infection or
                                                                                                                      A the womb. Because the treatment involved in
                                                                                                                        IVF involves replacing fertilised embryos into     together we want to have a baby of our
                                                                                                                                                                           own. What choices do we have?
                                                                                                                                                                                                                             couldn’t find anything wrong with me and
                                                                                                                                                                                                                             says he needs to see my husband. But he
  reasons for example polycystic ovary syndrome (PCOS).          operations, so that the sperm cannot get through
                                                                                                                        creating live embryos is long and hard for the
                                                                                                                                                                         A If not then you might want to consider this as
                                                                                                                                                                           Has your partner had his vasectomy reversed?      refuses to go.
• The eggs may not be released.
• There may be damage from ‘endometriosis’ or cysts.
                                                                 to meet the egg.                                       couple, and unfortunately there is a risk that
                                                                                                                        the embryos may still die once implanted, the      a first step. It is a delicate operation, which A A good start maythe firstexplain to the doctor
                                                                                                                                                                                                                             husband that in
                                                                                                                                                                                                                                               be to
                                                                                                                                                                                                                                                      instance,
                                                                                                                                                                                                                                                                 your

                                                                                                                           doctors try to increase the chances of a                 involves unblocking the tube which carries the              will probably just want to check out his overall
                                                                                                                           pregnancy by implanting several embryos at               sperm from the testicles to the penis. He                   health. This does not mean giving a semen
                                                                                                                           the same time. The authorities recommend                 would have to have an anaesthetic and would                 sample there and then as this is usually
                                                                                                                           that only two embryos are implanted, but in              need to stay in hospital for a day or so, but               carried out at assisted conception clinics. In
                                                                                                                           some circumstances they may allow three.                 there is a 30–70% chance that he would then                 some cases, men can make quite small
                                                                                                                           This obviously increases the chances of                  produce sperm as normal. Your second option                 changes to their lifestyles and improve their
Womb/uterus                                                    Cervix                                                      having a multiple birth. After discussion with           is to consider using a sperm donor (DI or                   sperm count. If your husband still refuses, you
• May be an abnormal shape, so the egg cannot implant itself   • May be partly opened so that infection gets in and        the doctor you will be given the choice of how           donor insemination). This would involve using               may need to talk about your feelings as in the
  and grow.                                                      damages the embryo.                                       many embryos are reimplanted, up to the                  sperm that was not your partner’s to make you               long term his refusal is likely to create tension
• May contain fibroids or polyps, (growths inside the womb),   • May produce hostile mucus that kills the sperm as         maximum of three.                                        pregnant. You might want to discuss this                    and resentment in your relationship.
  which prevent the egg from attaching itself.                   they try to swim through to fertilise the egg.                                                                     option very carefully with your partner before
                                                                                                                                                                                    taking it because he would not be the natural
                                                                                                                                                                                    father of the baby.
72                                                                                                                                                                                                                                                                                                    73
                                                                                                                                                                                                                                                                  Medical
                                                                                                                                                                                                                                                   problems conceiving


     What are the options for                                                                                                        For Men




     fer tility trea tment?                                                                                                          Treatment

                                                                                                                                     Fertility drugs
                                                                                                                                     ‘Mesterolone’
                                                                                                                                     and
                                                                                                                                     ‘gonadotrophin’
                                                                                                                                     to improve
                                                                                                                                     sperm count
                                                                                                                                                         How it works

                                                                                                                                                         Tablets or injections to increase the activity
                                                                                                                                                         of the testes.
                                                                                                                                                                                                             What it means for you

                                                                                                                                                                                                             Unfortunately the evidence suggests that drug treatment
                                                                                                                                                                                                             for men is not very effective.




                                                                                                                                     Varicocele          This is a short operation where the blocked         This is a short and painless operation so is worth
     Our quick guide gives you a summary of information, though your                                                                 treatment           vein in the testicle is tied off or removed with    trying as some men have an improved sperm
     assisted conception unit or fertility clinic will be able to provide you with                                                                       a chemical injection.                               count afterwards.
     information to meet your own needs.                                                                                             Reversing a         A delicate operation where the tiny narrow          The success rate varies from 35% to 71%.
                                                                                                                                     vasectomy           tube from the testes to the penis is unblocked.


     For Women                                                                                                                       Assisted conception
     Treatment         How it works                                       What it means for you                                      Treatment           How it works                                        What it means for you
     Fertility pills   Tablets for 5 days in each monthly cycle to        This treatment has a 65% success rate if the periods are   IUI (Intrauterine   Specially selected and washed sperm are             This method can be successful when there are problems
     ‘Clomiphene’      make the ovaries produce eggs regularly.           restored.                                                  insemination)       placed into the partner’s womb using fine           with the cervix or the man’s sperm quality.
                                                                                                                                                         plastic tubing. The woman usually takes
     HMG injections    Injections from the beginning of the cycle until   Has to be carefully monitored by your doctor. There is a                       fertility drugs beforehand.
                       just before ovulation to improve egg               higher risk of twins or triplets.
                       production. This treatment is used as part                                                                    DI (Donor           This is when sperm from a donor is put into a       Although the chances of a pregnancy are high, this needs
                       of IVF.                                                                                                       insemination)       woman’s vagina or womb. It is offered to            careful thinking about beforehand, because the woman’s
                                                                                                                                                         couples if the man has very few sperm, or           partner will not be the baby’s natural father.
     Pump therapy      Giving hormones through a pump worn on the         This is a good way to give hormones, because the pump                          has had a vasectomy, or carries an
                       arm to make the ovaries produce eggs.              mimics the body.                                                               inherited disease.

     Nasal spray       A spray into the nose every 4 hours. This slows    Particularly good for treating polycystic ovaries in       IVF (‘in vitro      This is where an egg is taken from the woman,       This is now a widely used procedure and has a one in
     ‘Buselin’         down the ovaries so they respond better            preparation for IVF.                                       fertilisation’ or   fertilised with her partner’s sperm in a test       five chance of success each time it is tried. However it
                       to HMG injections.                                                                                            test tube           tube and replanted into her womb.                   can be a lengthy and traumatic process for the couple.
                                                                                                                                     babies)
     Treatment for     This is done using drugs or microsurgery.          The success rate is variable so the surgery is only
     endometriosis                                                        recommended when the condition is severe.                  GIFT (gamete        Newer than IVF, this treatment involves taking      This is an alternative to IVF, which is sometimes
                                                                                                                                     intrafallopian      eggs from the ovaries, mixing them with             used when there is no obvious reason for the infertility.
     Tubal surgery     This involves operating on blocked or scarred      Although the results won’t be immediate, there is a 60%    transfer)           the partner’s sperm and immediately
                       fallopian tubes to open them up.                   chance of conception after the operation, depending                            replacing them into the fallopian tubes
                                                                          on the nature and extent of the tubal damage.                                  before fertilisation has taken place.

     Operating on the This can be a major operation to remove             There is a 65% to 75% chance of getting pregnant after     ICSI                A relatively new treatment, this is where an        This treatment has worked when IVF has failed and when
     uterus (womb)    fibroids or open up the cavity in the uterus.       successful surgery on the womb.                            (intracytoplasmic   individual’s sperm, which has been specially        the man has a low sperm count. It offers another chance
                                                                                                                                     sperm injection)    prepared, is injected directly into the partner’s   to couples who have been through all the other
                                                                                                                                                         egg. It is done to bypass any barriers to           treatments.
                                                                                                                                                         conception, such as blocked tubes.


74                                                                                                                                                                                                                                                                       75

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:4
posted:11/20/2011
language:English
pages:2